Suicide is the biggest killer of young lives in this country… And the rate is going up. Our mission must be, and will be, to get it down.
In a speech on healthcare on 22 May, the Labour leader Sir Keir Starmer said that the suicide rate is going up.
Labour has told us that Mr Starmer’s claim was based on data from the Office for National Statistics (ONS) for the rate of suicides registered in England and Wales, which does show a general rising trend between its low point in 2007 and 2021. However data for the last few years is less clear, and trends vary according to which year you start from.
Separate ONS statistics for the rate of suicides in England and Wales by when they occurred, rather than when they were registered, show that it has been broadly flat in recent years, with slight falls since 2019.
The recent data is also complicated by the pandemic and a change in 2018 to the way suicide is recorded. Professor Louis Appleby, a government advisor on suicide prevention and former national director for mental health, made these points in a Twitter thread on 22 May, in which he wrote: “Is the national suicide rate currently rising? Short answer: no.”
In a statement released by Labour before Mr Starmer’s speech, Dr Adrian James, President of the Royal College of Psychiatrists (RCP), originally said: “We support the Labour Party’s pledge to reverse rising rates of suicide.”
Following contact from Full Fact, the RCP changed its statement to read: “We support the Labour Party’s pledge to reduce rates of suicide.”
Any life lost by suicide is a terrible event. Public figures should try to describe this complex subject as accurately as possible, with appropriate context and caveats, to improve our chance of reducing the harm it causes.
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How is the suicide rate measured?
The ONS publishes age-standardised suicide rates for England and Wales by date of registration and by date of occurrence. The latest data on suicide registrations covers 1981 to 2021. There can be a significant delay between a suicide occurring and it being registered, so around half of each year’s registered suicides will have occurred in the previous year. The ONS has published provisional 2022 suicide registration rates for England only, while coroners’ statistics give 2022 registration data for England and Wales, but don’t provide an age-standardised rate.
The ONS also publishes data on suicide occurrences in England and Wales, covering 2013 to 2021. These figures are based on when deaths actually occurred, which means they are subject to revision after publication, as it can take months or even years for a suicide to be registered.
What do the different measures show?
Labour told us Mr Starmer’s claim referred to the rising rate of suicide registrations since their low point in 2007. It is true this rate has risen since then, from nine per 100,000 in 2007 to 10.7 per 100,000 in 2021, although it remains generally lower than it was in the 1980s and 1990s.
Whether suicide registrations have been rising recently depends partly on when “recently” begins. For instance, the rate of 10.7 per 100,000 in 2021 had risen since 2017, when it was 9.4 per 100,000, but fallen since 2019, when it was 11 per 100,000. In a press release distributed before Mr Starmer’s speech, Labour referred to a different source, saying: “Coroners statistics published earlier this month revealed that 2022 saw the highest number of suicides recorded in England and Wales.”
This is true, but it doesn’t necessarily mean the the suicide rate is rising, because it’s difficult to directly compare this data with previous years. It is not presented as an age-standardised rate, and the most recent data may have been affected by pandemic delays and changes in the way suicide is recorded (which we discuss below).
ONS data on suicide occurrences may give a more reliable picture of recent trends, because it is less affected by changing delays to inquests, although it is subject to possible revisions.
This appears to show relatively little change in the rate of suicides between 2013, when the dataset begins, and 2021. Again, there are periods in the data when the rate is rising, but it has fallen in the last two years, and was slightly lower in 2021 than in 2013, although the figures could be revised in future.
We don’t yet have clear data on the rate of suicides that occurred in 2022, which may eventually show that it rose or that it fell.
As the graph above shows, the data we have for occurrences in the past few years does not appear to give a clear picture. Professor Appleby said he believed the current trend was “not rising, but not falling either”, adding: “That should be concern enough.”
Recent disruption makes comparisons hard
In his Twitter thread, Professor Appleby highlighted two factors that he said made interpreting recent figures “problematic”. One was the impact of the pandemic, during which the delay between suicides occurring and being registered grew substantially. This may have caused a backlog in the system, leading to fewer suicides being recorded for a time—then more, as the system caught up.
The 2022 coroners’ statistics say: “There were 35,643 inquest conclusions recorded in 2022, up 3,321 (10%) from 2021, in part reflecting the change in the number of inquests opened and possibly due to a backlog caused by the Covid-19 pandemic.”
Suicides accounted for 14% of deaths recorded by coroners in 2022, down from 15% the year before.
Professor Appleby also mentioned a change in the way suicide is recorded, which happened in 2018.
In the words of the ONS: “The standard of proof – the level of evidence needed by coroners to conclude whether a death was caused by suicide – was changed from the criminal standard of ‘beyond all reasonable doubt’, to the civil standard of ‘on the balance of probabilities’ on 26 July 2018.”
The 2022 coroners’ statistics acknowledge this, saying: “The overall increase may be a consequence of the change in the standard of proof.”
However it’s not clear how much of an impact this change may have had to the overall statistics. The ONS says: “Since the change in the standard of proof, suicide rates have not seen unprecedented increases. Recent increases have been seen among English males and females, but these increases started before this change. Whenever a change in suicide rates occurs, the reasons are complex and will rarely be because of one factor alone.”
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Image courtesy of Rwendland